Provider Demographics
NPI:1831372978
Name:NORMAN A. BREST, MD DIVISON
Entity type:Organization
Organization Name:NORMAN A. BREST, MD DIVISON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BREST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-642-7714
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:MEDICAL BLDG. EAST SUITE 561
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-642-7714
Mailing Address - Fax:610-649-0761
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:MEDICAL BLDG. EAST SUITE 561
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-642-7714
Practice Address - Fax:610-649-0761
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMEN'S HEALTHCARE GROUP OF PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024417E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2666235OtherAETNA HEALTHPLAN
PA2346689000OtherINDEPENDENCE BLUE CROSS
PAB34055Medicare UPIN
PABR038051Medicare Oscar/Certification